When Breath Becomes Air: Pulitzer Prize Finalist

We live in a society that esteems the young, beautiful and vibrant above all things. We live in a society that thinks it is invincible and that we will live forever. Doctors are Gods who bring us miracles every day and the advances that they lead are truly astounding. We turn away from death embarrassed, scared, and nervous. When the doctors fail us we sue them. We want them to do everything they can to save us without any examination of what that means. This book is so beautiful and profound because Paul Kalanithi and his wife Lucy stand tall in the face of illness and death and just talk about it. This book is refreshing for its honesty and especially for Paul's refusal to give in to platitudes like, "We are going to beat it!" "We will win!" I understand why people choose that approach, but I think Paul's book and the way he lived his life after his diagnosis shows what a disservice that can be to living the life you have been handed. This is best exemplified in the exchange between Lucy and Paul about whether or not to have a child: ""Will having a newborn distract from the time we have together?" she asked. "Don't you think saying goodbye to your child will make your death more painful?" "Wouldn't it be great if it did?" I said. Lucy and I both felt that life wasn't about avoiding suffering." That's not to say that Paul did not fight his cancer. He did. He desperately wanted to live. But as he said "...I would have to learn to live in a different way, seeing death as an imposing itinerant visitor, but knowing that even if I'm dying, until I actually die, I am still living." I also liked this book for the lessons that physicians can learn from how they talk about treatment and death. I have been blessed to have dealt with some fantastic health care providers in recent years. The doctors and nurses who cared for my father when he was dying last year were fantastic, especially his oncologist. But there were some doctors and nurses who still seemed to side-step the conversation. I know they do not want to be wrong and that there is always hope, but there were so many euphemisms. Instead of telling us that he was in fact dying, there was a lot of talk about labs, and phrases like, "He is a very sick man." When I pressed they agreed wholeheartedly that my brother should come now. But no one said "death." No one said "dying." Paul's desire to understand human relationality and death lead him to medicine. He is honest that he was seeking a kind of transcendence there. But he comes to learn that, "As a resident, my highest ideal was not saving lives - everyone dies eventually - but guiding a patient or family to an understanding of death or illness." And that, "Openness to human relationality does not mean revealing grand truths from the apse; it means meeting patients where they are, in the narthex or nave, and bringing them as far as you can." I could share quote after quote here, but that understanding and transcendence is the meat of this book. Go read it! This book was sad because Paul was so talented and he left behind so much. He was a brilliant and thoughtful doctor. He was also an incredible writer. As I read his book, I was fascinated by his time as a neurosurgeon, but I was equally sad that he would not be writing any more. I wished he had chosen a writing career so that we would have more of his words to read. A writer that can use the word "pluperfect" so well to make his point and to capture his struggle with tense is wonderful. This is another example of his talent: "At moments, the weight of it became palpable. It was in the air, the stress and misery. Normally, you breathed it in, without noticing it. But some days, like a humid muggy day, it had a suffocating weight of its own. Some days, this is how it felt when I was in the hospital: trapped in an endless jungle summer, wet with sweat, the rain of tears of the families of the dying pouring down." The book was also sad because it was so clearly not finished. It felt like the solid beginning of a book and as I neared the end I was a little let down. But Lucy Kalanithi's Epilogue saved it for me. Lucy is a talented writer in her own right. Lucy's Epilogue gave the book the balance and the ending that it needed. Lucy writes, "Although these last few years have been wrenching and difficult - sometimes almost impossible - they have also been the most beautiful and profound of my life, requiring the daily act of holding life and death, joy and pain in balance and exploring new depths of gratitude and love." Lucy signs off her epilogue, "I was his wife and a witness." I loved this book for allowing me to witness Paul's journey. I was honoured to witness his death from afar. I hope this book reminds us all what an honour it is to witness life, and death in particular, and to embrace that more.

<WHEN BREATH BECOMES AIR>_PAUL KALANITHI Name : Paul Kalanithi Gender : male Age : 35 Occupation : neurosurgeon and neuroscientist Additional notes : great lover of literature, deep thinker, good person Symptoms : unexplained weight loss and new-onset back pain He was diagnosed with lung cancer and died of it. His devotion didn't falter, hitting arduous and wrenching bumps on the road. ==================== This book, a culmination of his love for literature, shows the inextricability of life and death. It is a cogent and powerful tale of living with death. It epitomizes the life of a man who faced death with integrity and genuinely struggled for existential answers to the question "what makes human life meaningful and worth living". It is of great strength. I read it twice. Such a rare thing for me, part of whom always yields to the rest craving for exploring a next book. So sorry for thinking of him leaving behind great contributions he, as a neurosurgeon and neuroscientist, would have made if he had lived, I could hardly let go of him and this book, proceeding to a new one the next. Even though I was extremely impressed on first reading and I thought I grasped what he meant to say through his book, I just wanted to spend more time with it. I chose to hear his voice again, like voiceover to be heard in a tv documentary, stifling the itch to write my review about it. I opened the first page for second reading. Knowing the whole story, my throat was choked up from the first sentence. With my heart breaking, I read it through. Sometimes I stopped at unlikely points which I went past on first reading, my eyes blurring with tears, aware of how Paul and Lucy felt and the way they coped when they've been through what came up to them. ==================== Saying "I'm sorry" is not an option for some professionals like neurosurgeons. TECHNICAL EXCELLENCE IS A MORAL REQUIREMENT. GOOD INTENTIONS ARE NOT ENOUGH(Paul Kalanithi). As if one letter makes difference in court, one or two millimeters would make the difference between tragedy and triumph in the OR. Paul was perfect for that part. Even though his fully-guaranteed future spreading down the road gave way to the death, the years of ministering to terminally ill patients and their families would bear fruit. Lucy, Paul's wife, in the picture, gives a bright and unwavering smile, holding their baby girl unsuspectingly grinning, snuggling up to him who has only several weeks left until his deathbed. She deserves to be loved by such a good man like Paul. In it, she doesn't give off any fear of his imminent death and impending burdens to be shouldered. ==================== I know them only in my capacity as a reader. But it never keeps me from missing and loving them. Like Atul Gawande's endorsement saying(BEING MORTAL is his book and I read it), the dying are the ones who have the most to teach us about life. Paul's love for what he'd been pursuing during his short-lived life, remains exquisitely beautiful here in this book and touching the hearts of readers.

An absolutely amazing book to read. I initially didn't want to read this book because I knew it would be sad. But then my dad was diagnosed with cancer and he would pass ten days later. The suddenness of it along with the hard reality of everything made me decide it was time to finally read this book, and I'm glad I did. The author's perspective on life and death is very refreshing and amazing to read. Dr Kalanithi was truly an inspiration that can revive some hope in humanity. I thought I would be sad for him, but I was more sad for everyone who lost him. He never talks about himself as being this or that, but just reading his words tell you so much about him and how he looked at life and death. The writing is very poetic, and visual. I would recommend this book to anyone and everyone and I'm thankful the Paul Kalanithi shared his story with us.

The best book I have every read. Written in almost a poetic manner. Sad story told in a magnificent way. Will probably read it again. Perfect title for the book.

When Breath Becomes Air is a book of two halves: the first is about becoming a doctor and saving life, the second about becoming a patient and facing death. As a young man, Kalanithi had struggled to find his true vocation. He found philosophy too dry and unreal, and science too divorced from human relationships. He had gained degrees in English Literature and in Human Biology, but was looking for an area where the various disciplines intersected. ‘What makes human life meaningful? I still felt literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain… 'There must be a way, I thought, that the language of life as experienced – of passion, hunger, love – bore some relationship, however convoluted, to the language of neurons, digestive tracts and heartbeats.’ He was in his fourth year at medical school when, sitting in on a meeting between a brain surgeon and the parents of a severely ill child, he finally realised that he should pursue neurology. The child had been diagnosed with a large brain tumour, most likely malignant. The surgeon had, he says, ‘not only delivered the clinical facts but addressed the human facts as well, acknowledging the tragedy of the situation and providing guidance… 'By the end of the conversation, the family was not at ease, but they seemed able to face the future’. A Christian, he was unembarrassed to regard the work of the neurosurgeon as a sacred calling. Every day, he would be confronted with questions of life and death, and of the meaning of existence. ‘Would you trade your ability – or your mother’s – to talk for a few extra months of mute life? How much neurologic suffering would you let your child endure before saying that death is preferable?’ Anyone who has ever been in a ward of patients with severe head injuries will understand what he means. You emerge perplexed by things you had previously taken for granted. How are these people related to who they were before? What is human consciousness? And, as Kalanithi himself puts it, what makes life meaningful enough to go on living? Part two of the book turns on when Kalanithi is diagnosed with terminal cancer, his role is immediately transformed from doctor to patient, and from active to passive. ‘As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask, “Why me?” (Answer: why NOT me?).’ His father tells him that he is going to beat cancer, that he will somehow be cured. ‘How often had I heard a patient’s family member make similar declarations? I never knew what to say to them then, and I didn’t know what to say to my father now.’ His marriage had been going through a rocky patch, but this brought them together. ‘In truth, cancer had helped save our marriage.’ In one of the most moving parts of the book, he and his wife discuss the possibility of having a baby. Lucy wants him to decide: he wants her to. ‘Don’t you think saying goodbye to your child will make your death more painful?’ she asks. ‘Wouldn’t it be great if it did?’ he replies, adding: ‘Lucy and I both felt that life wasn’t about avoiding suffering.’ In his quest for meaning, he avidly reads books about death – Tolstoy’s The Death Of Ivan Ilyich, Solzhenitsyn’s Cancer Ward, Montaigne’s Essays, and ‘anything by anyone who had ever written about mortality’. He was, he writes, ‘searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again’. He finds seven words by Samuel Beckett that sum up the paradox of his condition, its perfect balance of despair and hope: ‘I can’t go on. I’ll go on.’ For a time, he goes back to work, but then a fresh tumour develops. He goes through debilitating rounds of chemotherapy. The neurosurgery department determines that he has met all the criteria for graduation; the ceremony is scheduled for a fortnight before their baby is due. But as he is getting dressed for it, a terrible wave of nausea strikes him, and he starts vomiting uncontrollably. ‘I would not be going to graduation, after all.’ Their baby daughter, Cady, is born. She seems to give him the meaning for which he has been looking all his life. He realises that their lives will overlap only briefly, but writes her a simple message, to read some time in the future. It’s worth quoting in full: ‘When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.’ Paul Kalanithi died on March 9, 2015, not long after writing those words. His wife Lucy has contributed an extraordinarily moving epilogue, in which she describes his determination to keep writing his book right up to his last moment, sitting beneath a blanket, often having to wear gloves as a protection against the painful fissures on his hands due to the chemotherapy. ‘This book carries the urgency of racing against time,’ she says. Lucy Kalanithi writes of ‘a grief so heavy that at times I shiver and moan under the weight of it’. But she also rejoices that his memoir can ‘teach us to face death with integrity’. And, one might add, to face life with integrity, too.

If I had the ability to clone myself and travel in time to the future, sending useful notes to myself in the present, the message I would send myself about this book would be: "Read Part I and, time permitting, the epilogue. Skip the rest." I say this only after considerable thought, reluctant to imply any disrespect to the author. Dr. Kalanithi was clearly not only very a gifted and intelligent individual but also an exceedingly decent human being. His premature and tragic death represents not only a loss at a personal level but a tremendous loss for the medical and scientific community, in view of all the good that he would certainly have been able to accomplish for humanity. At the same time, I think that Dr. Kalanithi himself would not want anyone to give him a pass on his literary endeavor, on the basis of empathy for his personal situation. The author is at his best in Part I, which offers readers an intimate, inside look into the world of a practicing neurosurgeon. Those not familiar with this world will find Dr. Kalanithi's account both fascinating and enlightening, in its authenticity and honesty. Part II (about half the book) chronicles the development of the author’s illness. The story tugs at the heartstrings and is certainly dramatic in the most visceral sense of the word. Here the author struggles to impart any clear message, however, often getting bogged down in cumbersome literary analogies and lengthy quotations from a variety of poets, philosophers and other writers throughout the ages. As the author acknowledges toward the end of Part II, "I've been reading science and literature trying to find the right perspective but I haven't found it." In my own careful reading of the book, the closest I could find to any clear message is the author's assertion that "each of us can see only a part of the picture," with the truth to be found "somewhere above" all the different interpretations. He also mentions having "returned to the central values of Christianity" and "the main message of Jesus … that mercy trumps justice every time." These are entirely legitimate and worthy thoughts but is it worth wading through a hundred pages for them? I suspect that a good editor at a top publisher like Random House would have sent such a manuscript back to the author for extensive revision, IF he were alive. But this book of course was published posthumously. The author did not have the luxury of the time he would have needed to make this book truly top-notch. In the context of his pain and suffering, it is admirable that he managed to write what he did. In her moving epilogue, the author's wife, Lucy, writes that her late husband "wanted to help people understand death and face their mortality." Certainly this book serves to remind us of our mortality and, in so doing, of the importance of making informed decisions about how to live our lives. In this sense, it can certainly be considered a success. Daniel K. Berman, Ph.D., Amazon author The Newest Story of O: How to Legally Pay 0% Interest on the Money You Owe & Eliminate Your Debt in a Fraction of the Time—Secrets to Making the Credit System Work in Your Favor

When Breath Becomes Air, a Pulitzer Prize Finalist book, was something my son had mentioned multiple times as his birthday approached. He seldom reads for pleasure, so I knew he really wanted to get this book. I decided to order it for him. As expected, he loved it! I think he was truly surprised. I haven't read it yet, but I plan to. I have really enjoyed hearing him tell me different parts of the book, and it has really piqued my interest. I know as much as he likes it, it has to be great! When I asked him, he described it as a "MUST READ" and told me I had to read it. I am not an avid reader, and actually don't enjoy reading. However, he has raved about this book, so I kept it and plan to read it on our vacation in the RV to the beach. Maybe after I actually read it myself, I can give more details. What I can say is that he thought the book was great. He has convinced me to read it, and I haven't read a book for pleasure in probably 10 years. That tells you something! (Excuse the book jacket. The puppy chewed on it!)

I do not have the words to do this book justice. the loss of someone like Paul so young is so hard for me to understand. He served humanity so well as a physician and author. Paul, however, accepted his terminal illness and processed it with such grace, dignity and determination to continue to live well. His writing style is beautiful, thoughtful and evocative and makes me wish I could have known him. I didn't care for the long epilogue by his wife so my 5 star rating ignores that. A nice one page wrap up would have been more appropriate and she could save the rest to perhaps write a book of her own.

5\5 Not a fraction less. As I finished this book tears rolled down both my cheeks. Breathing was hard for the last 40 pages, as I struggle to choke back the conflicting emotions I felt in reading Paul's last words and those his wife Lucy would conclude with. On the one hand I felt heartbroken with sorrow for the fate of this man who would strive so hard to help others live or to ease the agony of those who would die. Yet this book was as heart wrenching as it was beautiful. It was as uplifting as it was sad. This book deeply touched me on an emotional and what some would call a spiritual level. While I am not spiritual, I cannot deny the spirit of this man, who lived, loved, triumphed and accepted his fate with courage and strength, even as cancer weakened him physiologically. Paul died very near my own age. I struggle to find meaning in life, especially as I see others die around me every year. I also grapple with my own impending end which could come any moment, future or present. I began to question everything as I've aged. I fear perhaps I have made the wrong choices in life. I question what it is all for. Being an atheist is a blessing and a curse, for it gives life at times a hollow definition. We live to die. Most of us spend the majority of our lives dying, or declining until our last day. This does not have to be a sad thing though. This book has revealed to me that there is another way in which to die. That is, to live... until death. From the bottom of my heart I am thankful to Paul, for this book, and to Lucy for her epilogue, for her kind words which will touch my own spirit, my core being, until the end. It will forever remind me that our fate may not always be what we want it to be but our lives are what we will make of them. We will all die, some sooner, some later. This is a fact. While we live to die this does not mean we cannot also live to live, to live life appreciatively. While I do not share the expansive and loving family Paul did and while I feel at times vastly alone in this world, I have learned the deep lessons of this book. I have no one to truly comfort me in my sorrows as I grind through life. This book, these words, are my comfort. Alone we embrace, this philosophy and I. I am not dying such as Paul was. I am merely dying as life would naturally have it, as we all are, until something decides to speed this natural process up, like a cancer or some other malignance. I merely suffer the physiological strife that comes with working on a farm in rural Nova Scotia. I toil so others may not. Someone must till the soil, grow the food, harvest from life to give life. Though I often feel I should be doing more. My English degree hangs on a wall, a banner of achievement, yet a reminder of failure. I relate to Paul in that, like him, I want to help others. After all, there is no better feeling than having consoled or counselled another. I have often had the dream of using words to ease the pain of suffering. Paul has awakened me to the fallacy of how I see that piece of paper in the negative. Perhaps I will do no more than I have. Some do nothing. Some live and die, forgotten to the winds of time. The important thing is to understand that life is a treasure. It is a thing to be cherished, this consciousness, this awareness, our ability to think and see and question and comprehend. To compel or be compelled is to live. Whether alone or in the company of loved ones, we should hold dear this thing we call life. Find your happiness where you can. Be it within the pages of a book such as this or in the company of others, seek it and embrace it, for a life lived happily is to truly live. Whether short or long, alone or otherwise, we need not despair the eventuality of our end. Smile, my fellows, for were we not alive, we would not know what it is to live. Thank you Paul. Thank you Lucy. You have both, in death, and life, warmed my heart beyond what other words have elsewhere been able.

This book is one of the best books I have ever read. Profoundly touching, it gives you a different perspective on life.

The paper used to make the book wasn't cut properly, leaving jaggered edges on the side of the book. Amazon didn't even bother wrapping the book up with bubble wrap to protect the book, so it arrived with damaged corners. I even had to swap the book once because it arrived with stains on the cover and horribly damaged edges. Overall a terrible experience...

ist mit diesem Buch sehr gut bedient. Es liefert für meine Bewertung zu viele neurochirurgische bzw. medizinische Details, die eigentlich für die Botschaft des Buches von untergeordneter Bedeutung sind. Viel erführt man auch über Hierarchie und Ausbildung der Ärzte im amerikanischen Gesundheitswesen. Trotzdem: Die Geschichte eines zukünftigen "Superstars" in der Neurochirurgie, sein mühsamer und von vielen Entbehrungen gekennzeichneter Weg an die Spitze der ärztlichen Kunst und sein Kampf mit seinem eigenen Lungenkrebs, den er letztendlich verliert, gerade dann, als er auf dem Zenit seines ärztlichen Könnens und seiner Reputation angekommen ist. Absolut ergreifend und lehrreich. Mit seinem eigenen Leiden konfrontiert, reift bei ihm die Erkenntnis: "Fame, money and status eventually all become meaningless". Wie wahr !! Das ist die zentrale Erkenntnis dieses Buches. Und dass es nur einen Weg aus der letztendlich sinnlosen Existenz des Menschen gibt: Die Liebe zu den Mitmenschen, das sich Bemühen um gute Beziehungen und die Geborgenheit und Befriedigung, in einer liebevollen Umgebung von Freunden, Bekannten, Kindern und dem Partner leben zu dürfen. Das Leben ist kurz. Liebe deine Mitmenschen, so lange du noch kannst und sroge dafür, dass die Welt nach dir ein leines Stück lebenswerter, friedlicher und menschlicher geworden ist. Vergiss nicht, wenigstens einige Menschen durch dein Wirken hier auf Erden etwas glücklicher zu machen. Unbedingt lesenswert.

La redacción es excelente, y el mensaje del libro va más allá de una simple lectura. Las experiencias narradas en la historia son conmovedoras y motivantes, y el tinte general del libro es muy alentador.